Doulas as childbirth paraprofessionals: Results from a national survey
Section snippets
Background
One of the many changes in childbirth in the United States during the 20th century was a decline in the presence of family members or friends providing support to a woman during labor and birth (Leavitt, 1999; van Teijlingen et al., 2000). Over the past two decades, however, there has been renewed interest in the use of “supportive caregivers” during childbirth (Hodnett et al., 2003; Klaus & Kennell, 1997). A critical component of “supportive care” is providing continuous support during the
Methods
This study was a cross-sectional survey of doulas in the United States and was approved by the Health Sciences Institutional Review Board at the University of Michigan. The study population included all doulas listed as certified or as having started but not yet completed certification by five professional doula associations: 1) Association of Labor Assistants and Childbirth Educators (ALACE); 2) Birth Works; 3) Childbirth and Postpartum Professional Association (CAPPA); 4) Doulas of North
Results
This sample of doulas is comprised of 471 (75.2%) certified and 155 (24.8%) yet-to-be certified doulas. The majority of doulas reported their ethnicity as white (93.8%), and respondents ranged in age from 20 to 71, with a mean age of 40.3 years. In addition, the majority of doulas were married (81.6%) and had given birth themselves (87.8%). Compared to certified doulas, not-yet-certified doulas were significantly younger, less likely to be white, and less likely to be married or have given
Discussion
It is difficult to estimate the number of doulas in practice in the United States. What is clear, however, is that the number of people who are seeking certification and who are offering doula services for a fee or as part of a hospital-based maternity care team is growing (Meyer, Arnold & Pascali-Bonaro, 2001; Morton, 2002). This article presents some basic descriptive information gathered from a national sample of doulas working as paraprofessionals in the United States in 2003. The results
Acknowledgements
This research was funded in part by a grant from the Walter McNerney Fund at the University of Michigan. Gratitude is extended to the organizations that provided mailing lists for the survey sample: Association of Labor Assistants and Childbirth Educators, Birth Works, Childbirth and Postpartum Professional Association, Doulas of North America, and International Childbirth Educators Association. In addition, appreciation is extended to all of the doulas and labor assistants who participated in
Paula M. Lantz, Associate Professor of Health Management and Policy at the University of Michigan School of Public Health, conducts policy-focused research on women’s health services and social inequalities in health.
References (25)
- et al.
Effects of providing hospital-based doulas in health maintenance organization hospitals
Obstetrics and Gynecology
(1999) The system of professionsan essay on the division of expert labor
(1988)Births, marriages, divorces, and deathsprovisional data for 2001
National Vital Statistics Review
(2002)Immaculate deception IIMyth, magic and birth
(1994)Birth as an American rite of passage
(1992)- et al.
Listening to mothersreport of the first national U.S. survey of women’s childbearing experiences
(2002) Mail and telephone surveys
(1978)- et al.
A guide to effective care in pregnancy and childbirth
(2000) An introduction to qualitative research
(1998)The medicalization and demedicalization of American society
Obstetric risks versus research realitiesa guide to the medical literature
Continuous support for women during childbirth (Cochrane Review)
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Paula M. Lantz, Associate Professor of Health Management and Policy at the University of Michigan School of Public Health, conducts policy-focused research on women’s health services and social inequalities in health.
Lisa Kane Low, Assistant Research Scientist in the School of Nursing and lecturer in Women’s Studies at the University of Michigan, is interested in women and adolescent’s experiences of childbirth and their association with processes of care during labor.
Sanjani Varkey, MPH, is interested in epidemiological perspectives on women’s health issues and global health.
Robyn L. Watson, is a doctoral student in Health Services Organization and Policy, University of Michigan, and is interested in research on the health care experiences of low-income minority women.